Standardizing Infusion Set Changes: A New Approach in Australian and New Zealand ICUs

Introduction:
Infusion sets are crucial in intensive care units (ICUs) for administering fluids and medications through central venous catheters (CVCs). The frequency of changing these sets can impact both patient safety and environmental sustainability.

Background:
Infusion sets, which include tubing, measuring burettes, fluid containers, and transducers, are regularly changed in an effort to prevent bacterial colonization and bloodstream infections. However, frequent changes also generate significant medical waste, and there is no evidence that frequent set changes prevent infection. Indeed, more frequent changes could pose risks to patient safety.

Current Practices:
A recent point prevalence survey conducted across 51 ICUs in Australia and New Zealand (ANZ) revealed varied practices. While one-third of the ICUs adhered to a 7-day replacement policy, most units opted for a more frequent replacement period, typically every 3-4 days.

Evidence and Recommendations:
High-level evidence suggests that extending the replacement period to 7 days does not increase infection risks for CVCs. This evidence supports a shift towards less frequent changes, balancing infection control with environmental considerations.

Conclusion:
The survey highlights a need to update guidelines and promote longer replacement intervals across ANZ ICUs. This change could enhance sustainability without compromising patient safety.

Read More: https://pubmed.ncbi.nlm.nih.gov/37385895/ 

Authors: Matthew H. Anstey, Nicky Maxwell, Claire M. Rickard, Naomi E. Hammond, Serena Knowles, Forbes McGain